Delivery of Self Training and Education for Stressful Situations-Telephone Version

This is a randomized controlled trial that will compare DESTRESS-T to Optimized Usual Care
(OUC). Optimized Usual Care is usual primary care PTSD treatment, plus a telephone care
management program that includes: four outreach calls, feedback to the treating primary care
provider (PCP), and care coordination.

Inclusion Criteria:

- Age>18 years

- DSM-IV diagnosis of PTSD (derived from the CAPS) due to combat in OIF/OEF deployment

- Active duty personnel

Exclusion Criteria:

- Active suicidal or violent ideation within the past two months as assessed by the
MINI and a supplementary form developed by the project team (see Appendices)

- Current participation in any active psychotherapy (e.g., psychoanalysis, CBT) for
mood, anxiety or substance use disorders (as determined via service member self
report and/or check of medical record)

- Recurrent PTSD treatment failure in psychotherapy, as determined via consensus of
study team members (Dr. Charles Engel, Dr. Brett Litz, and Dr. Kristie Gore)

- Current alcohol dependence, as assessed by MINI

- Acute psychosis, psychotic episode, or psychotic disorder diagnosis within the past
year, as assessed by the MINI

- Currently on an antipsychotic or mood-stabilizing agent for bipolar disorder or any
disorder with psychotic features, as determined by medical record and/or self report

- Unstable administration schedule or dosing of any antidepressant, anxiolytic, or
sedative-hypnotic (i.e., will exclude for any related medication changes in the month
prior to randomization), as determined by medical record or service member self
report

- Acute or unstable physical illness based on the judgment of the patient's primary
care clinician and the study team.